Keeping pregnant mums and new babies cool

Brisbane is known for its humid weather, and while luckily it's not quite as unpredictable as some neighbouring southern states, can still pack an unexpected punch in the heat department. Most people who live in Brisbane have learnt of ways to cope when the heat index becomes less bearable, but carrying an inbuilt heater inside while pregnant, or indeed feeding and comforting a new baby who is also feeling the heat, adds a whole new dimension to uncomfortable.

For pregnant ladies

While pregnant, women's core body temperate is raised higher than usual, thus making them more susceptible to heat sensitivity throughout a pregnancy. The circulating fluid and blood volume in the body is greater while pregnant, and while your body is doing its best to slowly adjusting to compensating for these changes, extreme heat may make you feel as though your body simply can't cope.

It is not unusual, at any time during pregnancy, but particularly during very hot and humid weather, for pregnant women to feel an increase in lethargy, nausea, leg cramps, swelling, light headedness, skin sensitivity and general irritability. Most people have become fairly reliant on air conditioning now, and this is certainly a great way to keep cool if you have access to it (and don't mind too much about a slightly higher than average power bill) but some other simple suggestions to keep cool while pregnant include;

Swimming;

swimming is fantastic for a whole range of reasons during pregnancy. It keeps you cool of course, assists with maintaining good levels of fitness, can assist with optimal fetal positioning as it promotes the baby to turn into a good position inside while your tummy faces forward/down, and it allows you to be weightless which gives your large joints and aching ligaments a break. It's not a good idea to swim using breaststroke kick for long periods as this can put strain on the ligaments in the pelvis, but a few laps alternating between freestyle is fine. Alternating, walking in the water or using a kick board or pool noodle to simply float and kick slowly may provide you all the reprieve you need.

Cold showers/ice buckets/wet cloths;

Most people have used these strategies before when feeling hot and bothered, and they certainly can be useful during pregnancy. Having a wet cloth, towel or sarong draped wherever it feels best is a fantastic way to keep cool, whether it across your tummy or around your shoulders, whatever gives you relief. We tend to control most our body temperature through our heads (among other methods) so often having something cold or wet across your forehead or back of your neck will make you feel cooler more quickly. Soaking your feet can also help to keep you comfortable, particularly if they are also swollen. If you can alternate between submerging your feet in cold water and having them elevated (but not cross-legged) this will help with both swelling and comfort. If you are having severe increases in swelling in your feet and hands which is accompanied by bad headaches and or visual disturbances, let the midwife know so we can check your blood pressure.

Increasing fluids and altering diet

It goes without saying that most people know to drink more water when you are feeling hot, and this is particularly important while pregnant. Aiming for 2-3L of water per day is a good way of making sure you stay well hydrated. Some people prefer to drink something flavoursome while very hot, and this is fine as long as your intake remains balanced; ie consuming lots of drinks that are very high in sugar is not a good idea, although they might taste good, they're not good for a heathy pregnancy, nor the best way of staying well hydrated. If you tend to sweat a lot during the hot weather, or the heat has caused your general nausea to turn into vomiting, then electrolyte drinks may be useful, but again, aren't necessarily good in large amounts. Munching on ice cubes is a very effective way of keeping cool, particularly as much of our heat is expelled through breathing. It can be useful to limit, but not completely eliminate salt from your diet, to allow the fluid in your body to be broken down most effectively. If the heat is putting you off eating decent meals, get creative with your snacks; freeze blueberries, grapes or orange segments or look up some recipes for making smoothie iceblocks and other snacks that help you stay cool, but maintain your intake and energy levels.

The most important thing you can do is try and stay relaxed, do things you enjoy and don't let the heat get you worked up (although it's tempting to throw a full adult tantrum when nothing you do is helping)! If you're uptight and anxious, upset and frustrated, your breathing quickens, your pulse and blood pressure rise, and your core temperature in fact becomes higher. So chill out (pun intended), make friends with someone with a pool or decent air conditioning if you're without these things at home, see every movie out if you need to, and drink plenty of water.

For new mums

Difficulty in staying comfortable in the heat doesn't end when pregnancy is over. If you happen to have a snuggly newborn during very hot and humid weather, the struggle may continue to be real.

Newborn babies want and need to be held, which is lovely and cute and sweet, but also very hot. Applying all the same strategies as above to help you stay cool while you have a newborn feeding frequently or needing comfort is a good idea, but most importantly remember that if you feel hot and sweaty, your baby likely does too.

During hot weather babies feed more frequently, to maintain good hydration for themselves. Breastfed babies don't require anything supplementary to breastmilk, as it contains everything they need, regardless of (and in fact specific to) the weather. During hotter days, breastmilk content changes to have a higher water consistency to allow your baby to be well hydrated, this is why it is important for them to feed frequently.

Babies feel the heat just as much as adults, so they should be dressed just like you too. The general rule for dressing a baby to climate is what you're wearing plus one layer when they're not being held. So, if it's sweltering and you are in your bare minimums, your baby should be too. In a house that isn't air conditioned it is perfectly suitable for a baby to be in a nappy and singlet only, with a thin muslin style wrap if they're sleeping solo in the bassinet. While feeding, if you are needing to be topless and near naked for comfort from the heat, they should be too. Your bodies will radiate heat from each other, so feed in an area where air flow is optimal. Similarly, if you have the aircon cranked high and you are comfortable in cotton clothes, that's what the baby should be in too, with a cotton wrap when not being held. Consider the airflow wherever your baby is; don't have them in the direct flow of an air conditioner or fan, nor in the car seat or pram for long periods, where airflow around their body is restricted.

Generally new babies will tell you if they're uncomfortable, but feeling their chest or back of their neck is a good indicator of temperate. If you want to use a thermometer, a traditional style one for under their arm is most effective and can be purchased from most pharmacies; the new wiz bang ones which zap their forehead don't have a lot of research backing, and anecdotally, are not very accurate.

The key signs for ensuring your baby is well and not suffering heat related illness, is watching for the same signs in them that you would in you - but being that they're smaller and more vulnerable, acting on symptoms of dehydration quickly. Ask yourself these key questions if you are concerned with your newborn during the heat;

Are they having lots of nappy changes?

Your baby's output should roughly mimic it's intake - so if they're feeding every 3-4 hours, you should expect 6-8 nappy changes per day, in combination of wee and poo.

Do they seem lethargic?

New babies do sleep a lot, but you should be able to notice uncharacteristic changes in behaviour. If they usually wake themselves for feeds when hungry, stay awake for a decent feed and react appropriately by opening their eyes and or telling you their cranky during nappy chances/baths and these things aren't happening, take them to be checked.

Are they dry?

Much like adults, when dehydrated, babies become dry. The skin is rougher and less mobile, the mucosa inside the mouth is paler pink and not as moist, and areas where bones aren't present may become sunken (in adults this tends to be around our eyes, in newborns it is evident in the anterior fontanelle; the soft spot on top of the head). This is generally last and most worrying sign of a dehydrated baby. If you notice these symptoms and some of the other symptoms listed in the previous two categories are present, don't hesitate in having your baby seen in emergency.

Much like the main suggestion is staying cool in pregnancy, staying relaxed and comfortable with a new baby is equally important. Trust your instincts, but also trust your body and your babies ability to work together to ensure good hydration and nutrition is maintained.

If you are concerned during your pregnancy about heat related illness call Arrivals and speak to the midwife, or if after hours, call Mater pregnancy assessment unit (3163 7000).

If you are concerned with the health of your newborn in relation to dehydration, you can also call Arrivals to seek advice from the midwife. If after hours, call Pregnancy, Birth and Baby to speak to a child health nurse (1800 882 436). If urgent concerns, present to Lady Cilento Hospital, next to Mater.

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